Toll like receptor expression induced by exercise in obesity and metabolic syndrome: A systematic review.
Exerc Immunol Rev. 2018;24:60-71
Authors: Rada I, Deldicque L, Francaux M, Zbinden-Foncea H
Abstract
BACKGROUND: Obesity and metabolic syndrome are disorders that correlate with the activation of pro-inflammatory pathways and cytokine production, to which Toll like receptors (TLR) contribute. Exercise may act as an anti-inflammatory modulator, but there is no consensus about the role of the TLR in this tuning. The present styudy aims to systematically review the current evidence on exercise-induced TLR regulation in animals and humans suffering from obesity and metabolic syndrome.
METHODS: Pubmed and Scopus databases were searched for publications from 1990 to September 2015. Search terms included: "Toll like Receptor", "TLR", "exercise", "obesity", "diabetes", and "metabolic syndrome". Elegibility criteria comprised: randomized control trials, cross-sectional and cohort studies; human or animal models with metabolic syndrome; any type of exercise; TLR expression measurement in any tissue by a clearly reported technique. The quality of selected studies was assessed using a modified version of the Downs and Black Quality Assessment Checklist. Data of study design; population; exercise type, timing and training elements; measurement technique, tissue analyzed and main outcome were extracted and categorized to facilitate data synthesis.
RESULTS: 17 studies were included, of which 11 publications obtained a high, 5 a moderate and 1 a low score for quality assessment. A total of 8 human studies were analyzed: 6 studies used endurance continuous or interval training protocols, 1 study resistance training and the remaining study was performed following a marathon race. Blood cells were analyzed in seven studies, of which four studies sampled peripheral blood mononuclear cells (PBMC), three analyzed whole blood and one study sampled skeletal muscle. Nine animal studies were included: 8 used endurance training and 1 acute aerobic exercise. A variety of tissues samples were explored such as PBMC, skeletal muscle, adipose, vascular and nervous tissue. Globally, the animal studies showed a marked tendency towards a down-regulation of TLR2 and 4 expression accompagnied with, a reduced activation of nuclear factorkappaB (NF-κB) signaling and cytokine production, and an improvement in insulin sensitivity and body composition.
CONCLUSION: While animal studies showed a marked tendency towards TLR2 and 4 down-regulation after chronic endurance exercise, the current evidence in human is not sufficiently robust to conclude any role of TLR in the anti-inflammatory properties of exercise.
PMID: 29461969 [PubMed - in process]

Anxiety and perceived psychological stress play an important role in the immune response after exercise.
Exerc Immunol Rev. 2018;24:26-34
Authors: Edwards JP, Walsh NP, Diment PC, Roberts R
Abstract
There are common pathways by which psychological stress and exercise stress alter immunity. However, it remains unknown whether psychological stress plays a role in the in vivo immune response to exercise. We examined the relationship between anxiety and perceived psychological stress reported before exercise and in vivo immunity after exercise using skin sensitisation with Diphenylcyclopropenone (DPCP). In a randomised design, sixty four, thoroughly familiarised, males completed widely used psychological instruments to assess state-anxiety and perceived psychological stress before exercise, and ran either 30 minutes at 60% (30MI) or 80% (30HI) V . O2peak, 120 minutes at 60% (120MI) V . O2peak or rested (CON) before DPCP sensitisation. Cutaneous recall to DPCP was measured as the dermal thickening response to a low-dose series DPCP challenge 4-weeks after sensitisation. After accounting for exercise (R2 = 0.20; P < 0.01), multiple-regression showed that pre-exercise state-anxiety (STAI-S; ΔR2 = 0.19; P < 0.01) and perceived psychological stress (ΔR2 = 0.13; P < 0.05) were moderately associated with the DPCP response after exercise. The STAI-S scores before exercise were considered low-to-moderate in these familiarised individuals (median split; mean STAI-S of low 25 and moderate 34). Further examination showed that the DPCP response after exercise (30MI, 30HI or 120MI) was 62% lower in those reporting low vs. moderate state-anxiety before exercise (mean difference in dermal thickening: -2.6 mm; 95% CI: -0.8 to -4.4 mm; P < 0.01). As such, the results indicate a beneficial effect of moderate (vs. low) state-anxiety and perceived psychological stress on in vivo immunity after exercise. Moreover, correlations were of comparable strength for the relationship between physiological stress (heart rate training impulse) and the summed dermal response to DPCP (r = -0.37; 95% CI: -0.05 to -0.62; P = 0.01), and state-anxiety and the summed dermal response to DPCP (r = 0.39; 95% CI: 0.08 to 0.63; P < 0.01). In conclusion, state-anxiety and perceived psychological stress levels before exercise play animportant role in determining the strength of the in vivo immune response after exercise. These findings indicate a similar strength relationship for the level of state-anxiety prior to exercise and the level of physiological stress during exercise with the in vivo immune response after exercise. Future research is required to investigate exercise-immune responses in athletes, military personnel and others in physically demanding occupations experiencing higher levels of psychological stress than those reported in this study e.g. related to important competition, military operations and major life events. Nevertheless, the present findings support the recommendation that exercise scientists should account for anxiety and psychological stress when examining the immune response to exercise.
PMID: 29461966 [PubMed - in process]

Tethered Swimming Test: Reliability and the Association to Swimming Performance and Land-based Anaerobic Performance.
J Strength Cond Res. 2018 Feb 14;:
Authors: Nagle Zera J, Nagle EF, Nagai T, Lovalekar M, Abt JP, Lephart SM
Abstract
The purpose of this study was three-fold: (a) to examine the test-retest reliability of a 30 second maximal tethered freestyle swimming test (TST), (b) to assess the validity of the TST by examining the association to sprint swimming performance and, (c) to examine the associations between a swim-specific and land-based measure of anaerobic performance. A total of twenty-nine male and female swimmers were recruited to participate in the study. Each participant completed a Wingate Anaerobic cycling test (WAnT), two or four TST, and a 22.9 meter (25 yard), 45.7 meter (50 yard), and 91.4 meter (100 yard) maximal freestyle performance swims (PS). Mean and peak force (Fmean, Fpeak) were recorded for both the WAnT and TST, and average swimming velocity and time were recorded for the PS. Additionally, physiological and perceptual measures were recorded immediate post exercise for all tests. The results of the present investigation showed strong intersession and intrasession reliability (R= 0.821-0.975; p<0.001) for force parameters of the TST. Moderate correlations were found between Fmean and PS time and velocity of all distances, with slightly weaker correlations between Fpeak and the 22.9 meter (time and velocity) and 45.7 meter (velocity) PS. Finally, moderate correlations were found for Fmean and Fpeak of the TST and WAnT. This study demonstrated that the TST is a reliable measure, with moderate association to swimming performance, producing similar physiological responses compared to free swimming. Therefore, future research shoulSd focus on investigating the potential benefits of utilizing the TST as a regular assessment tool as a part of a competitive swimming training program to track adaptations and inform training decisions.
PMID: 29461421 [PubMed - as supplied by publisher]

Validity and Reliability of an on-Court Fitness Test for Assessing and Monitoring Aerobic Fitness in Squash.
J Strength Cond Res. 2018 Feb 14;:
Authors: James CA, Vallejo FT, Kantebeen M, Farra S
Abstract
Current on-court assessments of aerobic fitness in squash are not designed to yield a wealth of physiological data. Moreover, tests may require complex computer equipment or involve simulated racket strokes, which are difficult to standardize at high intensities. This study investigated the validity and reliability of a squash-specific fitness test which can yield both a standalone performance score, as well as pertinent physiological markers such as V[Combining Dot Above]O2max, the lactate turnpoint and oxygen cost, in a sport-specific environment. Eight national squash players completed three tests in a counter-balanced order; an incremental laboratory treadmill test (LAB) and two on-court fitness tests (ST) that involved repeated shuttle runs at increasing speeds. V[Combining Dot Above]O2max during ST was agreeable with LAB (Typical error [TE]=3.3 mL.kg.min, r=0.79). The mean bias between LAB and ST was 2.5 mL.kg.min. There were no differences in maximum heart rate, post exercise blood lactate concentration or end of test RPE between LAB and ST (p>0.05). The ST was highly reliable, with 74 (10) laps completed in ST1 and 75 (12) laps in ST2 (mean bias=1 lap, TE=3 laps, r=0.97). Physiological markers were also reliable, including V[Combining Dot Above]O2max, (TE=1.5 mL.kg.min, r=0.95), the lap number at 4 mMol (TE=4 laps, r=0.77) and average VO2 across the first 4 stages (TE=0.94 mL.kg.min, r=0.95). We observed good agreement between LAB and ST for assessing V[Combining Dot Above]O2max and between both on-court trials for assessing test performance and selected physiological markers. Consequently, we recommend this test for monitoring training adaptations and prescribing individualized training in elite squash players.
PMID: 29461414 [PubMed - as supplied by publisher]

Related Articles
Promoting ADL independence in vulnerable, community-dwelling older adults: a pilot RCT comparing 3-Step Workout for Life versus resistance exercise.
Clin Interv Aging. 2017;12:1141-1149
Authors: Liu CJ, Xu H, Keith NR, Clark DO
Abstract
BACKGROUND: Resistance exercise is effective to increase muscle strength for older adults; however, its effect on the outcome of activities of daily living is often limited. The purpose of this study was to examine whether 3-Step Workout for Life (which combines resistance exercise, functional exercise, and activities of daily living exercise) would be more beneficial than resistance exercise alone.
METHODS: A single-blind randomized controlled trial was conducted. Fifty-two inactive, community-dwelling older adults (mean age =73 years) with muscle weakness and difficulty in activities of daily living were randomized to receive 3-Step Workout for Life or resistance exercise only. Participants in the 3-Step Workout for Life Group performed functional movements and selected activities of daily living at home in addition to resistance exercise. Participants in the Resistance Exercise Only Group performed resistance exercise only. Both groups were comparable in exercise intensity (moderate), duration (50-60 minutes each time for 10 weeks), and frequency (three times a week). Assessment of Motor and Process Skills, a standard performance test on activities of daily living, was administered at baseline, postintervention, and 6 months after intervention completion.
RESULTS: At postintervention, the 3-Step Workout for Life Group showed improvement on the outcome measure (mean change from baseline =0.29, P=0.02), but the improvement was not greater than the Resistance Exercise Only Group (group mean difference =0.24, P=0.13). However, the Resistance Exercise Only Group showed a significant decline (mean change from baseline =-0.25, P=0.01) 6 months after the intervention completion. Meanwhile, the superior effect of 3-Step Workout for Life was observed (group mean difference =0.37, P<0.01).
CONCLUSION: Compared to resistance exercise alone, 3-Step Workout for Life improves the performance of activities of daily living and attenuates the disablement process in older adults.
PMID: 28769559 [PubMed - indexed for MEDLINE]

Related Articles
Effects of Pelvic and Core Strength Training on High School Cross-Country Race Times.
J Strength Cond Res. 2017 Aug;31(8):2289-2295
Authors: Clark AW, Goedeke MK, Cunningham SR, Rockwell DE, Lehecka BJ, Manske RC, Smith BS
Abstract
Clark, AW, Goedeke, MK, Cunningham, SR, Rockwell, DE, Lehecka, BJ, Manske, RC, and Smith, BS. Effects of pelvic and core strength training on high school cross-country race times. J Strength Cond Res 31(8): 2289-2295, 2017-There is only limited research examining the effect of pelvic and core strength training on running performance. Pelvic and core muscle fatigue is believed to contribute to excess motion along frontal and transverse planes which decreases efficiency in normal sagittal plane running motions. The purpose of this study was to determine whether adding a 6-week pelvic and core strengthening program resulted in decreased race times in high school cross-country runners. Thirty-five high school cross-country runners (14-19 years old) from 2 high schools were randomly assigned to a strengthening group (experimental) or a nonstrengthening group (control). All participants completed 4 standardized isometric strength tests for hip abductors, adductors, extensors, and core musculature in a test-retest design. The experimental group performed a 6-week pelvic and core strengthening program along with their normal training. Participants in the control group performed their normal training without additional pelvic and core strengthening. Baseline, 3-week, and 6-week race times were collected using a repeated measures design. No significant interaction between experimental and control groups regarding decreasing race times and increasing pelvic and core musculature strength occurred over the 6-week study period. Both groups increased strength and decreased overall race times. Clinically significant findings reveal a 6-week pelvic and core stability strengthening program 3 times a week in addition to coach led team training may help decrease race times.
PMID: 27893484 [PubMed - indexed for MEDLINE]

Related Articles
Resistance Training Improves Sleep Quality in Subjects With Moderate Parkinson's Disease.
J Strength Cond Res. 2017 Aug;31(8):2270-2277
Authors: Silva-Batista C, de Brito LC, Corcos DM, Roschel H, de Mello MT, Piemonte MEP, Tricoli V, Ugrinowitsch C
Abstract
Silva-Batista, C, de Brito, LC, Corcos, DM, Roschel, H, de Mello, MT, Piemonte, MEP, Tricoli, V, and Ugrinowitsch, C. Resistance training improves sleep quality in subjects with moderate Parkinson's disease. J Strength Cond Res 31(8): 2270-2277, 2017-The objectives of this study were to test if 12 weeks of progressive resistance training (RT) improves sleep quality and muscle strength in subjects with moderate Parkinson's disease (PD) and if sleep quality values of subjects with moderate PD are closer to those of age-matched healthy controls (HC) at posttraining. This was a randomized controlled trial conducted between March 2013 and September 2014. Twenty-two subjects with moderate PD were randomly assigned to a nonexercising control group (n = 11) or an RT group (n = 11). Thirty-one HC were not randomized to any group. The RT group performed a RT program twice a week for 12 weeks, whereas the control group made no change to their weekly routine. For subjects with PD, sleep quality (i.e., Pittsburgh Sleep Quality Index [PSQI]) and knee-extensor peak torque were assessed before and after 12 weeks of intervention; for HC, these outcomes were assessed at pretest only. There were differences between RT and control groups in PSQI scores, PSQI subscores(i.e., subjective sleep quality and daytime dysfunction), and knee-extensor peak torque at posttraining (p ≤ 0.05). After RT, the average subjects with PD showed lower (i.e., improved) PSQI scores than the average HC (p ≤ 0.05). A negative association was observed between changes in PSQI scores and changes in knee-extensor peak torque at posttraining (r = -0.58, p = 0.028). No adverse events were reported. The RT is recommended as an adjunct therapeutic method for improving sleep quality of subjects with moderate PD and moving these levels to those observed in HC.
PMID: 27787472 [PubMed - indexed for MEDLINE]

Related Articles
Establishment and Evaluation of an Anterior Cruciate Ligament Injury Prevention Program.
Orthop Nurs. 2016 May-Jun;35(3):161-71
Authors: Liebert R
Abstract
BACKGROUND: In female high school athletes, soccer continues to be a high-risk sport for sustaining an anterior cruciate ligament injury. Literature reviews indicate the best injury prevention programs (IPPs) focus on increasing core strength and proprioception in this age group.
PURPOSE: An IPP was created for a small Midwestern high school girls' soccer team. The goal of the study was to evaluate the effectiveness of the IPP on core strength and proprioception.
METHODS: The IPP incorporated functional movement applied science and exercises. Students were tested pre- and postseason. Results were analyzed using paired-samples t tests.
RESULTS: Statistically significant results in improved core measures were noted.
CONCLUSION: This IPP, which utilized functional movement and training, could be utilized by other teams for increasing core strength and proprioception of players, as well as adding to the body of literature utilizing functional movement.
PMID: 27187221 [PubMed - indexed for MEDLINE]

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